Comparison of spinal anesthesia with combined sciatic-femoral nerve block for outpatient knee arthroscopy.
OBJECTIVE
To compare spinal anesthesia and combined sciatic-femoral nerve block for outpatient knee arthroscopy.


METHODS
Prospective, randomized, controlled study.


METHODS
Postoperative recovery area at a university-affiliated medical center.


METHODS
50 ASA physical status I and II adult outpatients undergoing arthroscopic knee surgery.


METHODS
Study subjects were equally divided (n = 25 each) into spinal and sciatic-femoral groups. Spinal group patients received spinal anesthesia with 7.5 mg of 0.5% hyperbaric bupivacaine. Sciatic-femoral group patients received combined sciatic-femoral nerve blocks using a mixture of 20 mL of lidocaine 2% plus 20 mL of bupivacaine 0.5%.


METHODS
Times including that from arrival in the operating room to readiness for surgery, duration of surgery, recovery time, and patient satisfaction were recorded. Analgesia and occurrence of adverse events also were recorded.


RESULTS
No significant differences between the two groups were found for any of the study measurements of recovery. After discharge, postoperative pain differed significantly between groups only at 6 hours (P < 0.002). Patient satisfaction was high with both techniques.


CONCLUSIONS
Combined sciatic-femoral nerve block for outpatient arthroscopic knee surgery offers satisfactory anesthesia, with a clinical profile similar to that of low-dose spinal anesthesia. Sciatic-femoral nerve blocks are associated with significantly lower pain scores during the first 6 postoperative hours.
Montes
Felix R
FR
Department of Anesthesiology, Fundación Cardio Infantil-Instituto de Cardiología, Universidad del Rosario, Bogotá, Colombia. felix.ramon.montes@gmail.com
Zarate
Eduardo
E
Grueso
Reinaldo
R
Giraldo
Juan C
JC
Venegas
Maria P
MP
Gomez
Andrea
A
Rincón
Jose D
JD
Hernadez
Marcela
M
Cabrera
Mariana
M
D000556:Ambulatory Surgical Procedures; D000775:Anesthesia, Spinal; D001182:Arthroscopy; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D012584:Sciatic Nerve; D013997:Time Factors; D016896:Treatment Outcome